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Nowadays, the analysis of hematopoiesis in patients with acute lymphoblastic leucosis includes only quantitative characteristics of residue myeloid process of bone marrow. The evaluation of myelodysplasia is unexplored still. The analysis of myelopoiesis was carried on sampling of 108 patients with primary acute lymphoblastic leucosis (27 - T-acute lymphohlastic leucosis, 81 - B-acute Iymphoblastic leucosis). The characteristics of dysplasia of granulocytes, erythroid cells and megakaryocytes were based on the parameters of WHO classification of acute myeloid leucosis (2001). The monolinear dysplasia was established in 35 patients (32.4%). multilinear dysplasia--in 9 patients (8.3%). Under T- acute lymphoblastic leucosis the bilinear dysplasia was detected reliably more often and absence of dysplasia more rare than under B-acute lymphoblastic leucosis. The signs of dysplasia of various myeloid lines had no inter-correlation and had no dependencies from indicators of expression of early antigens (CCD34 and TdT) and myeloid antigens (CD13, CD33). The comparison of factual data with indicators of dysplasia under acute mteloid leucosis (181 patients) demonstrated that rates of uni- and multilinear dysplasia under T-acute Iymphoblastic leucosis and acute myeloid leucosis have no significant difference. The myelodysplasia is detected reliably (more often under B-acute lymphoblastic leucosis as compared with acute myeloid leucosis.

Examinations of 174 children and 188 adult patients with acute nonlymphoblastic leukemia (ANLL) demonstrated a similar structure of distribution of ANLL FAB-variants in children and adults, although the incidence of M0 and M4 blasts was somewhat higher in infants aged under 2. In patients under 15 and over 60 peroxidase activity in myeloblasts was reliably lower than in the rest patients. HLA-Dr, Thy-1, CD11a, T-CD19, Gly-A, and Eb antigens were equally incident in the cells of children and adults. The expression of CD11b, CD38, and CD10 antigens on the blasts was higher in children than in adults. An abnormal blast karyotype was detected in 81.8% children and 73.7% adults. Translocation (8;21) was observed in patients with the M2 variant, as a rule (82%), and reliably more frequently in children; t(9;22) and t(11q23) occurred in children somewhat more frequently than in adults. A group of children with primary ANLL (n = 3) was distinguished for the first time, in whose cell karyotype a deletion of chromosome 5 was found. The findings indicate that the biological characteristics of blast cells differ in children and adults. Evidently, the level of hemopoiesis involvement in ANLL is earlier in infants under 2 and subjects over 60 than in the rest patients.

Expression of new Mab D11 on blood and bone marrow cells was investigated in 85 hemoblastosis patients. In normals, antigen D11 is expressed on some monocytes and all tissue macrophages. D11 was noted on lymphoblasts of 5 out of 10 cases with B-cell ALL and of 1 case in B-lymphoid blast crisis of chronic myeloid leukemia. In T-ALL, ANLL, non-Hodgkin's lymphomas in leukemization stage, hairy cell leukemia and chronic lymphoid leukemia the cells were nonresponsive to Mab D11. Unlike D11 which have round nuclei, lymphoblasts D11+ have folded nuclei and more pronounced cytoplasmic basophilia. There were both B and myeloid antigens on D11+ blasts. ALL D11+ patients had extramedullary foci, more suppressed granulocytic and thrombocytic components of hemopoiesis, shorter remissions than those with ALL D11-.

Twenty-five patients with acute lymphoblastic leukemia [15 adults and 10 children] received standard treatment in which regular L-asparaginase was replaced for L-asparaginase of prolonged action [PEG-asparaginase]. The drug was administered once in two weeks in a dose 2500 IU/m2 for remission induction and consolidation or as a component of maintenance therapy. It was found that the response to primary PEG-asparaginase treatment or its use in the disease relapses produced the same response as regular L-asparaginase, being superior in convenience and feasibility of outpatient use. Side effects in the form of hypoproteinemia, hepatic toxicity and toxic pancreatitis [in children, 9 and 1 adults, respectively] were moderate and disappeared after 10-20-day discontinuation of the drug.

Morphocytochemical and immunologic features of the bone marrow and peripheral blood lymphoid elements were studied in 40 patients with B-prolymphocytic lymphosarcoma in the stage of leukemic degeneration. Four types of pathologic lymphoid cells were distinguished: large prolymphocytes expressing pan-B CD19 and HLA-Dr antigens, medium-sized prolymphocytes with round nuclei, characterized by activation CD38 and CD45Ra antigens, prolymphocytes with split nuclei containing light and heavy immunoglobulin chains, and leukemic lymphocytes containing, besides pan-B antigens and immunoglobulins, antigens of the early hemopoietic (CD34) and early B-(CD10) precursors. The content of the RAS-positive substance in the prolymphocytes was inversely proportional to the parameters of activation antigens expression. Acid phosphatase activity correlated with the expression of CD22 and CD45Ra antigens.

Phenotyping of blood cells derived from 12 patients with chronic myeloid leukemia in blast crisis with the use of Mab panel to differentiation antigens of human hemopoietic cells in a flow cytofluorimeter revealed heterogeneity of immunological phenotypes of blast cells. Subclones of blast cells were detected within each subset of disease at several successive stages of differentiation. The qualitative and quantitative composition of cell populations differing in immunological parameters is changed as a result of therapy given.

Immunophenotyping was conducted in 14 patients with malignant lymphoma of the skin using 4 monoclonal antibodies against CD4, 4, 8 and HLA (Ia--like) antigens. OKT4+ cells were detected in all the patients and OKT3+ cells in five of them. The expression of Ia-like antigen was noted in all patients with varying duration of the tumor process, in some of them Ia-like antigen prevailed that evidenced T-cell activation at all the stages of the tumor process in T-lymphomas of the skin. The highest expression of Ia-like antigen was recorded at the erythrodermal stage of granulomatosis of OKT4+ and OKT3+ phenotypes. Less pronounced expression of epidermal Ia-like tumor cells may be an evidence of a more benign course of the process.

The incidence rate of acute mixed-lineal leukemias, distinguished in a group of patients with acute non-lymphoblastic leukemia, in children and adults was about the same: CALLA 10-20%, T-cell antigens 15-22%, Thy-1 15-17%. The incidence rate of acute lymphoblastic leukemia with myeloid (17-21%) and erythroid (12-13%) antigens did not significantly differ in children and adults. Distinguishing features have been proposed for actual acute mixed-lineal leukemias having markers of mature stages of varying cell line differentiation from cryptic lineal-different-marker leukemias of bi- or polypotent precursor-cell origin.

The antigen detectable with monoclonal antibodies ICO-11 was studied in cells of 33 patients with acute lymphoblastic leukemia (ALL) and 47 patients with acute non-lymphoblastic leukemia (ANLL). The incidence rate of antigen-positive cases in ALL comprised 39.4%, in ANLL 35.4%. The presence of antigen in blasts in ALL did not influence the disease prognosis. The presence of ICO-11+ blasts in ANLL was characteristic of the group of patients with more favourable prognosis: a higher survival rate, due to a higher frequency of remissions, a longer life-time in the absence of remission. Basing on the clinico-hematological data ICO-11+ group could not be identified as more favourable prognostically.

Correlation analysis of the clinical course and prognosis was made in 56 children with T-cell lymphoblastic tumors (acute lymphoblastic leukemia and lymphosarcoma) typed with the use of monoclonal antibodies obtained in this country. The frequency of T-cell marker detection among all immunological subvariants in acute lymphoid leukemia and lymphosarcoma proved to be similar (36.6 and 37%, respectively). In acute lymphoid leukemia type T1 of tumor cells prevailed (58%), while in lymphosarcoma type T3 (63%). T2 and T3-cell lymphoblastic tumors were characterized by the most severe clinical course.

It has been found that kinetic parameters of proliferation in a dominating clone of bone marrow blast cells with Ia-positive and Ia-negative phenotype, as well as with expression of myeloid differentiating antigens (ICO-GM1 and ICO-G2), or in the absence of these antigens, do not significantly differ in children with subvariants MO-M4 of acute nonlymphoblastic leukemia, sensitive and resistant to the therapy. A higher rate of the bone marrow blast cell population growth and a lower effectiveness of the combined chemotherapy have been recorded in children with T-cell and pre-B-cell acute lymphoblastic leukemia as compared to acute lymphoblastic leukemia with the phenotype of blast cells that have only Ia-like or "common" antigens.

Seventy-two children with acute nonlymphoblastic leukemia (ANLL) have been studied for expression of different antigens on blast cells with the use of monoclonal antibodies. Myeloid antigens (C3bi; X-hapten) were identified on blast cells most frequently, 58.3%, Ia-like antigen was found in 55% and LFA-1 in 34% of cases. The expression of all antigens except that of LFA-1 was independent on FAB-subtype. It seems necessary in clinical practice to type ANLL cells for the expression of T-cell and myeloid antigens that are of prognostic significance.

A comparative study of Ph'-positive and Ph'-negative blast cells of patients with acute leukemia (12 and 63, respectively) has revealed certain differences between them: Ph'-positive elements were more often characterized by a mixed immunological phenotype, they could grow in agar culture. The therapy of Ph'-positive leukemia was less effective than that of Ph'-negative disease.